# MARTIN DENTAL-AIRPARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Martin Dental Airpark
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073156709
- **Authorized official:** LEANNA GONZALES (OFFICE COORDINATOR)
- **Authorized official phone:** (480) 498-4191

## Contact information

- **Practice address:** 1775 E QUEEN CREEK RD STE 130, CHANDLER, AZ 85286-2012
- **Practice address phone:** (480) 498-4191
- **Practice address fax:** (480) 586-7160
- **Mailing address:** 20556 E PECAN LN STE 130, QUEEN CREEK, AZ 85142-0504
- **Mailing address phone:** (480) 498-4191
- **Mailing address fax:** (480) 586-7160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2019
- **Last updated:** 10/25/2019